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https://www.readbyqxmd.com/read/28550704/integrating-engagement-and-improvement-work-in-a-pediatric-hospital
#1
Mireille Brosseau, Diane Gagnon, Kristina Rohde, Jennifer Schellinck
Although geared towards a common goal - improved patient-centred care - quality improvement strategies and patient engagement-focused approaches are often developed and conducted in silos. The lack of integration may lead, on the one hand, to the uptake of patient suggestions that do not always take into consideration implications for the delivery of quality care and, on the other hand, to inadequate understanding of patient views required to create optimal services. The Children's Hospital of Eastern Ontario (CHEO)'s action plans to address gaps in patient engagement and quality improvement, two of its priority areas, were initially carried out in isolation of each other...
2017: Healthcare Quarterly
https://www.readbyqxmd.com/read/28550703/improving-patient-engagement-and-satisfaction-lessons-from-a-patient-driven-care-initiative-in-a-community-based-hospital
#2
Lisa Shiozaki, Kirsten Burgomaster, Manon Lemonde
Lack of collaboration and alignment between members of the healthcare team interfere with the patient-centred care approach. The Patient-Driven Care Project was initiated in 2012. This model sought to advance a system of care that is patient-driven, family-centred and provider-guided to improve the value to patients and give them more control on their health journey. The evaluation revealed that the efforts should focus on sustainability and continuation of support and encouragement of hospital colleagues to ensure each patient and family experience is based on caring communication at every interaction with them...
2017: Healthcare Quarterly
https://www.readbyqxmd.com/read/28550700/optimizing-transitions-of-care-hospital-to-community
#3
Emily Sheridan, Christine Thompson, Tania Pinheiro, Nicole Robinson, Karen Davies, Nancy Whitmore
Discharging patients from the hospital is a complex process, and preventing avoidable readmissions has the potential to improve both the quality of life for patients and the financial sustainability of the healthcare system (Alper et al. 2016). Improving the discharge process is one method to mitigate readmission to the hospital. Historically, St. Thomas Elgin General Hospital (STEGH) consistently experienced higher-than-expected readmission rates, and only 41% of discharge summaries were sent from the hospital to the community primary care within 48 hours...
2017: Healthcare Quarterly
https://www.readbyqxmd.com/read/28550698/boomr-better-coordinated-cross-sectoral-medication-reconciliation-for%C3%A2-residential-care
#4
Vincent Vuong, Denis O'Donnell, Hrishikesh Navare, Debra Merrill, Michal Racki, Sheila Burton, Lori Anderson, Carla Beaton
There is evidence that medication errors often arise during the transition of residents from acute care to long-term care (LTC) homes due to lapses in communication and documentation. Better Coordinated Cross-Sectoral Medication Reconciliation (BOOMR) is an integrated practice change improving medication safety during patient transitions through the health system. Our Medication Reconciliation (MedRec) redesign improved patient engagement using "the patient's story," increased quality of information, workflow efficiency and reduced unnecessary medications...
2017: Healthcare Quarterly
https://www.readbyqxmd.com/read/28550693/healthcare-for-the-aging-citizen-and-the-aging-citizen-for-healthcare-involving-patient-advisors-in%C3%A2-elder-friendly-care-improvement
#5
Jennifer Verma, Patricia O'Connor, Jerold Hodge, Howard Abrams, Jocelyn Bennett, Samir Sinha
With an aging population and a healthcare system that is overly reliant on providing expensive and sometimes problematic hospital-based care for older Canadians, driving improvements that promote elder-friendly care has never been more critical. The Acute Care for Elders (ACE) Strategy at Toronto's Mount Sinai Hospital is the focus of a pan-Canadian collaborative delivered by the Canadian Foundation for Healthcare Improvement in partnership with the Canadian Frailty Network. The intent is to spread the ACE Strategy's elder-friendly models of care and practices to 18 participating healthcare delivery organizations...
2017: Healthcare Quarterly
https://www.readbyqxmd.com/read/28550251/when-patient-engagement-and-research-ethics-collide-lessons-from-a-dementia-forum
#6
Julie M Robillard, Tanya L Feng
The importance of patient engagement in research has been gaining recognition since the turn of the 21st century. However, little is known about the perspectives of people with dementia on the process of discovery. To fill this gap and to inform priorities in patient engagement in the context of dementia research, the Clinic for Alzheimer Disease and Related Disorders at the University of British Columbia hosted an interactive session for members of the patient community and of the general public to share their views on various ethical aspects of the research process...
May 26, 2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/28550008/prioritizing-measures-of-digital-patient-engagement-a-delphi-expert-panel-study
#7
Lynn A Garvin, Steven R Simon
BACKGROUND: Establishing a validated scale of patient engagement through use of information technology (ie, digital patient engagement) is the first step to understanding its role in health and health care quality, outcomes, and efficient implementation by health care providers and systems. OBJECTIVE: The aim of this study was to develop and prioritize measures of digital patient engagement based on patients' use of the US Department of Veterans Affairs (VA)'s MyHealtheVet (MHV) portal, focusing on the MHV/Blue Button and Secure Messaging functions...
May 26, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28550005/perceptions-of-patient-engagement-applications-during-pregnancy-a-qualitative-assessment-of-the-patient-s-perspective
#8
Maren Goetz, Mitho Müller, Lina Maria Matthies, Jenny Hansen, Anne Doster, Akos Szabo, Jan Pauluschke-Fröhlich, Harald Abele, Christof Sohn, Markus Wallwiener, Stephanie Wallwiener
BACKGROUND: With growing demand for medical information and health applications in pregnancy, the potential of electronic health (eHealth) and mobile health (mHealth) solutions in clinical care is increasingly unfolding. However, we still do not know how pregnant women engage with mobile apps, how such apps impact routine medical care, and whether benefit expectations are met. Whereas recent research has raised the subject of user distribution and analyzed the content of pregnancy applications, there is still a significant knowledge gap regarding what pregnant women like and dislike about pregnancy tools, along with how such interventions could be improved...
May 26, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/28550001/more-than-a-text-message-dismantling-digital-triggers-to-curate-behavior-change-in-patient-centered-health-interventions
#9
Frederick Muench, Amit Baumel
Digital triggers such as text messages, emails, and push alerts are designed to focus an individual on a desired goal by prompting an internal or external reaction at the appropriate time. Triggers therefore have an essential role in engaging individuals with digital interventions delivered outside of traditional health care settings, where other events in daily lives and fluctuating motivation to engage in effortful behavior exist. There is an emerging body of literature examining the use of digital triggers for short-term action and longer-term behavior change...
May 26, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28549765/improving-patient-centered-transitional-care-after-complex-abdominal-surgery
#10
Alexandra W Acher, Stephanie A Campbell-Flohr, Maria Brenny-Fitzpatrick, Kristine M Leahy-Gross, Sara Fernandes-Taylor, Alexander V Fisher, Suresh Agarwal, Amy J Kind, Caprice C Greenberg, Pascale Carayon, Sharon M Weber
BACKGROUND: Poor-quality transitions of care from hospital to home contribute to high rates of readmission after complex abdominal surgery. The Coordinated Transitional Care (C-TraC) program improved readmission rates in medical patients, but evidence-based surgical transitional care protocols are lacking. This pilot study evaluated the feasibility and preliminary effectiveness of an adapted surgical C-TraC protocol. STUDY DESIGN: The intervention includes in-person enrollment of patients...
May 18, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28549750/shared-decision-making-in-brazil-concrete-efforts-to-empowering-patient-s-voice
#11
Mirhelen Mendes de Abreu, Joao Pedro Simao de Mello, Lilah Ferreira F Ribeiro, Luiza Andrade Mussi, Mariana Luiza L Borges, Maurício Petroli, Nycholas da Costa Tavares, Rafael da Cunha Cancela, Sabrina Fausto de Lima
Patient involvement in healthcare decisions has grown in Brazil at three different levels: 1) the macro level, which includes the patient actively influencing legislation and regulation of medical care as well as political changes in the process of care itself; 2) the meso level, which includes institutions that aim to improve information, empowerment and counseling to patients, and 3) the micro level, which focuses on the actual decision-making process that takes place within patient-physician encounter. In Brazil, the macro and meso levels are stronger than the micro one...
May 23, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28549480/improving-the-appropriateness-of-antipsychotic-prescribing-in-nursing-homes-a-mixed-methods-process-evaluation-of-an-academic-detailing-intervention
#12
L Desveaux, M Saragosa, J Rogers, L Bevan, H Loshak, A Moser, S Feldman, L Regier, L Jeffs, N M Ivers
BACKGROUND: In 2014, nursing home administration and government officials were facing increasing public and media scrutiny around the variation of antipsychotic medication (APM) prescribing across Ontario nursing homes. In response, policy makers partnered to test an academic detailing (AD) intervention to address appropriate prescribing of APM in nursing homes in a cluster-randomized trial. This mixed-methods study aimed to explore how and why the AD intervention may have resulted in changes in the nursing home context...
May 26, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28549479/engaging-the-canadian-public-on-reimbursement-decision-making-for-drugs-for-rare-diseases-a-national-online-survey
#13
Julie Polisena, Michael Burgess, Craig Mitton, Larry D Lynd
BACKGROUND: Funding of drugs for rare diseases (DRDs) requires decisions that balance fairness for all individuals within the healthcare system with compassion for affected individuals. Our study objective was to conduct a national online survey to determine the Canadian public's perspective, including regional variations, associated with DRD decision-making. METHODS: The survey collected responses from 1631 Canadians. Respondents were asked to rank at least three and up to five DRD decision-making priorities, out of a total of eight priorities presented...
May 26, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28548634/predictors-of-permanent-disability-among-adults-with-spinal-dysraphism
#14
Matthew C Davis, Betsy D Hopson, Jeffrey P Blount, Rachel Carroll, Tracey S Wilson, Danielle K Powell, Amie B Jackson McLain, Brandon G Rocque
OBJECTIVE Predictors of permanent disability among individuals with spinal dysraphism are not well established. In this study, the authors examined potential risk factors for self-reported permanent disability among adults with spinal dysraphism. METHODS A total of 188 consecutive individuals undergoing follow-up in an adult spinal dysraphism clinic completed a standardized National Spina Bifida Patient Registry survey. Chi-square tests and logistic regression were used to assess bivariate relationships, while multivariate logistic regression was used to identify factors independently associated with self-identification as "permanently disabled...
May 26, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28546876/self-monitoring-symptoms-in-glaucoma-a-feasibility-study-of-a-web-based-diary-tool
#15
Leanne McDonald, Fiona C Glen, Deanna J Taylor, David P Crabb
Purpose. Glaucoma patients annually spend only a few hours in an eye clinic but spend more than 5000 waking hours engaged in everything else. We propose that patients could self-monitor changes in visual symptoms providing valuable between clinic information; we test the hypothesis that this is feasible using a web-based diary tool. Methods. Ten glaucoma patients with a range of visual field loss took part in an eight-week pilot study. After completing a series of baseline tests, volunteers were prompted to monitor symptoms every three days and complete a diary about their vision during daily life using a bespoke web-based diary tool...
2017: Journal of Ophthalmology
https://www.readbyqxmd.com/read/28546779/emerging-treatment-options-for-the-management-of-hodgkin-s-lymphoma-clinical-utility-of-nivolumab
#16
REVIEW
David A Bond, Lapo Alinari
Classical Hodgkin's lymphoma (cHL) is a B-cell malignancy comprised of pathologic Reed Sternberg cells with a surrounding immune-tolerant inflammatory milieu. RS cells evade immune recognition in part through programmed death ligand 1 (PD-L1) overexpression, which is genetically programmed through copy number alterations, polysomy, and amplification of the 9p24.1 locus encoding PD-L1. By engaging with PD-1+ T-cells, PD-L1 delivers a potent immune suppressive signal promoting immunologic escape of the tumor cell...
2017: Journal of Blood Medicine
https://www.readbyqxmd.com/read/28546510/towards-high-reliability-organising-in-healthcare-a-strategy-for-building-organisational-capacity
#17
Hanan J Aboumatar, Sallie J Weaver, Dianne Rees, Michael A Rosen, Melinda D Sawyer, Peter J Pronovost
In a high-reliability organisation (HRO), safety and quality (SQ) is an organisational priority, and all workforce members are engaged, continuously learning and improving their work. To build organisational capacity for SQ work, we have developed a role-tailored capacity-building framework that we are currently employing at the Johns Hopkins Armstrong Institute for Patient Safety and Quality as part of an organisational strategy towards HRO. This framework considers organisation-wide competencies for SQ that includes all staff and faculty and is integrated into a broader organisation-wide operating management system for improving quality...
May 25, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28545538/providing-online-weight-management-in-primary-care-a-mixed-methods-process-evaluation-of-healthcare-practitioners-experiences-of-using-and-supporting-patients-using-power
#18
Emily Smith, Katherine Bradbury, Lisa Scott, Mary Steele, Paul Little, Lucy Yardley
BACKGROUND: An online weight management intervention (POWeR+) combined with a small amount of primary care healthcare practitioner support is effective in helping patients to lose weight, but little is known about how practitioners interact with the POWeR+ intervention or their experiences of providing support for patients using POWeR+. The aim of this study was to explore practitioners' usage of POWeR+ and their experiences of providing support to patients using POWeR+. METHODS: Set within a randomised controlled trial of POWeR+, practitioners' usage of POWeR+ was automatically captured and a qualitative process analysis was conducted employing semi-structured telephone interviews with practitioners who provided support to patients using POWeR+...
May 25, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28545504/a-case-report-of-zinc-phosphide-poisoning-complicated-by-acute-renal-failure-and-tubulo-interstitial-nephritis
#19
Nilukshana Yogendranathan, H M M T B Herath, Thenuka Sivasundaram, R Constantine, Aruna Kulatunga
BACKGROUND: Run Rat® is a rodenticide widely used against small mammals. It comprises of a minimum of 32% zinc phosphide which is highly toxic in acute exposures to humans. It may be consumed accidentally or intentionally. It enters the body via skin, respiratory and gastrointestinal tracts. Zinc phosphide is hydrolyzed by the gastric acid and is transformed into phosphine gas. Phosphine is a respiratory toxin that inhibits cytochrome C oxidase system resulting in renal failure and liver failure...
May 25, 2017: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28545493/three-approaches-to-glucose-monitoring-in-non-insulin-treated-diabetes-a-pragmatic-randomized-clinical-trial-protocol
#20
Laura A Young, John B Buse, Mark A Weaver, Maihan B Vu, April Reese, C Madeline Mitchell, Tamara Blakeney, Kimberlea Grimm, Jennifer Rees, Katrina E Donahue
BACKGROUND: For the nearly 75% of patients living with type 2 diabetes (T2DM) that do not use insulin, decisions regarding self-monitoring of blood glucose (SMBG) can be especially problematic. While in theory SMBG holds great promise for sparking favorable behavior change, it is a resource intensive activity without firmly established patient benefits. This study describes our study protocol to assess the impact of three different SMBG testing approaches on patient-centered outcomes in patients with non-insulin treated T2DM within a community-based, clinic setting...
May 25, 2017: BMC Health Services Research
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